Monday, December 22, 2014
by Attorney Nick Wearne
Some work related injuries have special laws that govern whether they are compensable and how much benefit can be received. One such law is Arizona Revised Statutes Section 23-143. This section tells us what is required for a hernia to be covered under workers compensation. A hernia is defined as a condition in which part of an abdominal organ protrudes through the abdominal muscles that are supposed to contain it. Hernias are placed in two different categories according to the law: 1) Real Traumatic Hernias, and; 2) All other hernias.
A Real Traumatic hernia is an injury caused by a cut, puncture, or tear to the stomach or groin area that cuts through the skin and causes an exposure or protrusion of abdominal organs. These types of hernia injuries can be life threatening and we do not see them very often.
Hernias more often occur when a person is lifting, twisting, or moving while handling something heavy. There is no puncture of the skin but organs break through the abdominal wall causing a bulge beneath the skin. These types of hernias, regardless of how they occur, are considered to have existed since birth or to have formed over many years and are not compensable under workers compensation, unless you can prove 4 things:
1) The cause of the hernia was a sudden effort or severe strain related to your employment
One of the hardest things about hernia cases is that when our clients go to the doctor immediately after they will often tell the doctor about all the groin pain they have ever had in the past. The doctor will usually make note of this in the medical record. Even though such groin pain is almost always unrelated to the hernia and caused by sore muscles or gas, the insurance company uses the medical record to suggest that the hernia was of a gradual onset and not caused by a sudden event. Such cases become much more difficult to win.
2) The decent or popping out of the hernia occurs immediately
The hernia bulge has to have occurred at the same time or immediately after the sudden effort or strain. The hernia bulge consists of organs protruding through your abdominal wall and occasionally can be pushed back into the abdomen or will go away when you lie down. Because they have pushed the bulge back in, sometimes clients will tell the doctor they have no hernia bulge or protrusion. Before long these clients will strain and the hernia will protrude once again through their injured abdominal wall. Such cases become more difficult to win because insurance companies suggest that the bulge did not occur till long after the original strain.
3) You experienced severe pain during the incident
a. At the time of the strain or effort you must have experienced severe pain. When you go to the doctor following a hernia, it is not the time to try and prove you have a high pain tolerance. Be truthful with your doctor regarding the pain you experienced at the time of the event.
4) The pain and hernia bulge were of such severity that you reported them to your supervisor
a. You must report you hernia to a supervisor immediately. If you do not report it immediately your cases becomes difficult, if not impossible, to win. Do not try and tough it out as this could be detrimental to both your health and your case.
If you have experienced a hernia at work, and feel you may be entitled to compensation, you need to hire an experienced workers compensation attorney to help you get the benefits you need. Contact our offices toll-free at 855-325-4781. You can also visit us online at www.workinjuryaz.com to read more about our firm and attorneys.